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A~mP~I~ ' -'-N FOR SA~N1� �� � � PERMIT permit No. <br /> (Complete in Duplicate) 'Issued Date Issued <br /> ires-1-Y-or-from-Date <br /> .-'--Thi s-Perm it-Ex install the work herein described. <br /> Application is hereby made to the San Joaquin Loca- <br /> with County dinanCe No. 549. <br /> Ord <br /> This application is made in compliance A10 fi --------------------- <br /> Contractor's Name---------------- rt Cj Motel Other [j <br /> Installation will serve- Resid nce Ej<Agartment House 0 Commercial 0 Trailer Cou 11 ---------------- <br /> N mber of baths <br /> n er Table 4( <br /> '-g-,'Community Sy Adobe Ey--Aardpan 0 <br /> c system <br /> Water supply: Publi,'� andy Loam 0 Clay Loam El <br /> depth of 3 feet:.,-Sand C] Gravel [I S A e No 0— <br /> Previous Application �Aade: Yes El <br /> TYPE OF INSTALLATION AND SP <br /> (No septi6 tank or cesspool Permitted if public sewer-"S available within 200 feet.) <br />' -istance �n/ � <br /> No. of compartments <br /> Disposal Field: Distance <br /> Numbeof x""^ material <br /> -e from founda ---.bistance to nearest <br /> ' <br /> Seepage Pit: Number <br /> to '=~'`~' well, --- Lining muforo| ��o� Diameter Lining <br /> ' \� <br /> Num6erofp��-'x'-'''- material- �^ � U�nq <br /> ` u� — � material <br /> o�n------------------------------------- <br /> foundation <br /> --'---- <br /> Co�pop- Di�nnco from n�nn^� we.\ ----Oi��»c« �om �nu� Copoory_----------------------------gals. <br /> ------- - - <br /> [] Size: D�meter —'''-'--'—'--Dept _----'' f - - 'r6ui|6io --------------------------------- ----- <br /> ------------------ <br /> sta <br /> nce <br /> ro <br /> ------------ <br /> ' ------------------------------------------------------------ <br /> _-- '''-''--''--.--��-____-___—_-- -''-'__.' ._----._..-----._----- <br /> -'-'-'—''�-'''- -------'-^-'--''' ��h �mn County <br /> ----------------------------------------'---'--' 6 that +6� work will 6o 6mn� in accordance � ,�--`_� . <br /> ared this application <br /> ' ' hereby certify' uin Local Health District.6 <br /> ordinances, State laws, and rules n <br /> ------------- <br /> lacid on reverse side). <br /> ' <br /> By ��a��n "" ,el,.~.re lations of the San Joaci <br /> _ . .^ <br /> (plot plan, showing size of lot, <br /> FOR DEPARTMENT USE ONLY <br /> ' ________._______ DATE�---'��--~'�-'- —'--- <br /> ApPUC/g�\[)N ACCEPTED BY--..l+m�*,?�----'_----'_______.___--' D/�E___________________ <br /> REV|EVVED 0Y'-------''---''--'---'--''--'--'_ � __''-_'________ D/A'E'---'---'------''------ ' <br /> 8U|LD|N�' PER��\T ISSUED---_----_-._-_-- ______ ______ <br /> � -._-_-_-.. � _______.__. <br /> A�*,aMnno mnJ/*, recommendations:--------. . ___________________--..�-_______.___ __ <br /> ------------------------ <br /> - -I� J� ____ <br /> FINAL iNsPECTIO BY:-- -- --------- ------------ ----- -----(-- -- - <br /> SAN JOAQUIN LOCAL HEALTH DISTRICT <br /> 1re--Sfree+ 814 North "C" Street <br /> 3DO West Oak Stiiet_�% .32 Sycam*. Tracy, California <br /> 130 south Arnericart Street LoJi, California Manteca, California <br /> Stockton, California <br /> �Sv-,m Re�ised 6-m,rCo. <br /> ���� <br />